For many people, trauma is not a single, isolated event. It is not one moment in time, but something that happens repeatedly over months or even years. This kind of trauma doesn’t just hurt-it shapes how a person sees themselves, others, and the world. We refer to it as Complex Post-Traumatic Stress Disorder, or C-PTSD.
Although C-PTSD is not officially recognized in the Diagnostic and Statistical Manual of Mental Disorders (the DSM-5), it is becoming increasingly recognized by mental health professionals and those living with the very real effects of this condition. The World Health Organization has included C-PTSD in the International Classification of Diseases (ICD-11), highlighting what many already know: that prolonged trauma creates a different kind of impact-one that goes beyond the current criteria for PTSD.
PTSD often stems from a single incident, whereas C-PTSD is associated with a sustained and repeated experience-such as childhood neglect, ongoing abuse, or captivity. The symptoms can be more complex and pervasive and show up in everyday struggles with relationships, emotional regulation, low self-esteem, or feeling disconnected from yourself and the world around you.
In this post, we’ll explore what makes C-PTSD unique, how symptoms show up in daily life, and empowering steps that can be taken towards healing.
What is C-PTSD?
C-PTSD is the result of multiple, repeated traumatic events which take place over time. There are many different causes and symptoms tend to vary from person to person. While PTSD has long been recognized in clinical settings, it often doesn’t fully explain the long-term effects of repeated trauma, especially when that trauma begins in childhood or takes place in environments where escape wasn’t possible. As awareness grows, many people are finding that C-PTSD, and its associated symptoms, fits their reality more closely than a traditional PTSD diagnosis. While research is still in the early stages, it is estimated that 1-8 per cent of people worldwide may have C-PTSD. Since it is not currently recognized in the DSM, it is possible for some people to be given a diagnosis of PTSD instead. What we know so far is that women are more likely to be diagnosed with C-PTSD than men, and children are the most at risk of developing the condition.
Common Causes
The most well-known causes of C-PTSD include, but are not limited to:
- Childhood abuse or neglect
- Traumatic injuries
- Intimate partner violence
- Repeated sexual victimization
- Exposure to war, conflict, or combat
- Witnessing traumatic events
It is possible for someone to experience more than one traumatic event at the same time. For example, someone exposed to childhood neglect may also be the victim of a traumatic injury.
Complex PTSD Symptoms
Some common symptoms of C-PTSD include, but are not limited to:
- Flashbacks (visual or auditory)
- Hypervigilance
- Anxiety
- Elevated emotional responses
- Difficulty maintaining relationships
- Low self-esteem
- Depersonalization
- Dissociation
It is important to remember that the experience of C-PTSD is unique for everyone. While one person may have certain symptoms, another person may have completely different ones.
How is C-PTSD different from PTSD?
What makes C-PTSD different from the more well-known PTSD? While the two conditions have several similarities, there are aspects of C-PTSD that set it apart. Have a look at the chart below to see which symptoms appear for both diagnosis, and which are unique to C-PTSD.
| Symptom | PTSD | C-PTSD |
| Re-experiencing trauma | X | X |
| Avoiding reminders of the trauma | X | X |
| Hypervigilance | X | X |
| Low sense of self-worth | X | |
| Interpersonal difficulties | X | |
| Affect dysregulation | X |
As we can see, C-PTSD includes the symptoms of traditional PTSD with the added concerns of low self-worth, difficulties in relationships with others, and emotional dysregulation. These symptoms should not be overlooked as they cause great upheaval in daily life and warrant attention.
C-PTSD Treatment
C-PTSD is a life-long mental health condition that is deserving of proper treatment and care. It is important to reach out to the right helping professionals who can provide education, assess your needs, and support you with managing symptoms. Some great clinical treatment options include:
Counselling for PTSD: Talk Therapy
It can be nice to have someone hear you out and discuss your experience in a safe, non-judgemental environment. Depending on your therapist, sessions may include validation for what you have been going through, education regarding what you are experiencing, and brainstorming for how to effectively manage symptoms.
Cognitive Behaviour Therapy (CBT) Trauma Therapy
CBT can be used to identify unhelpful thoughts, emotions, and behaviours that are maintaining a negative experience. These can then be shifted to include different perspectives and foster greater enjoyment of life.
Eye Movement Desensitization and Reprocessing (EMDR) Therapy
This form of treatment involves moving your eyes in a specific way as you think about and process traumatic memories. The goal is to help overcome the trauma and make it easier to cope with. It is recommended to work only with an EMDR-trained therapist when choosing this option.
Supporting Yourself with Self-help Strategies
While working with a licensed professional is incredibly important when healing from C-PTSD, there are a few things you can do at home to support yourself. Depending on your preferences and personality, you may want to try a few of the following coping skills:
- Weekly, intentional self-care
- Staying connected with family and friends
- Breathing exercises or meditation with a trained teacher
- Practicing a new hobby
- Keeping a journal
- Positive words of affirmation
- Establishing healthy boundaries
- Validating your own emotions. It’s ok to feel what you are feeling!
- Pay attention to your body. Are you feeling overwhelmed? What can you do right now to support yourself?
If you think you may be struggling with C-PTSD, know that management and healing are possible. At Island Clinical Counselling, we have experienced counsellors who are specifically trained in the above-mentioned therapy approaches. Most of our counsellors are well versed in CBT and how it can be used in sessions to reclaim a sense of self, reframe experiences, and build emotional resilience. For trauma recovery in Nanaimo/Parksville/Duncan/Port Alberni, connect with us today. We also have EMDR-trained counsellors in our Nanaimo, Parksville, and Duncan locations. Reach out today to book your first appointment!
Written by Cat Zydyk
References:
Brickel, R.E. (2021, July 9). How is CPTSD different from PTSD? Brickel & Associates, LLC. https://brickelandassociates.com/how-is-cptsd-different-from-ptsd/
CPTSD Foundation. (n.d.) What is complex post-traumatic stress disorder? https://cptsdfoundation.org/what-is-complex-post-traumatic-stress-disorder-cptsd/
Golden, C. (n.d.) A guide to complex post-traumatic stress disorder. Nami Mercer. https://namimercer.org/wp-content/uploads/2024/07/A-Guide-to-CPTSD.pdf